JP2011234746A - Double balloon type endoscopic system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a double balloon type endoscopic system capable of being easily inserted in a digestive tract up to a deep part and reducing the pain of a subject even in case that the endoscopic system is inserted up to the deep part.SOLUTION: In the double balloon type endoscopic system 10A constituted so that the fixing balloon 15 of an endoscope body 11 is provided to the outer periphery on the side of the distal end of the endoscope body 11 and a fixing balloon 14 is provided to the outer periphery on the side of the distal end of a sliding tube 12, the propelling balloon 16A of the endoscope body 11 is arranged between the distal end part of the sliding tube 12 and the endoscope body 11 to be fixed not only to the proximal end of the fixing balloon 15 of the endoscope body 11 on the side of the distal end side thereof but also to the distal end of the sliding tube 12 on the proximal end thereof. A gas flow channel 13a for introducing and sucking gas into the propelling balloon 16A of an insertion instrument is formed to the sliding tube 12 or the endoscope body 11.

Description

  The present invention relates to a double-balloon endoscope device, and more particularly, a double-balloon endoscope that can be easily inserted into the deep digestive tract and is less painful to the subject even when inserted deep. The present invention relates to a mirror device.

  Endoscopes are medical devices that are primarily intended for observing the inside of the human body. Currently, various devices for endoscopic procedures that perform direct treatment or sample collection under endoscopic observation are used. Those equipped are also developed and put to practical use. Endoscopes are roughly classified into rigid, flexible, and capsule types depending on the structure. Especially when observing the digestive tract such as the large intestine and small intestine, flexible endoscopes that can be used for treatment as well as diagnosis are the mainstream. It has become.

  A general endoscope (flexible endoscope) is a distal end side of a tube made of a flexible material (distal end side viewed from the endoscope operation unit side. Hereinafter, it is expressed as “distal end side”). An optical system for observation, an ultrasonic sensor, etc. are attached to the tube, and cables for light sources and detectors, and various device operation cables for performing endoscopic procedures are passed through the tube. It has a structure and is inserted into the digestive tract orally, nasally or transanally, and introduced to the target site for observation and various treatments. In the digestive tract, the small intestine is far from the mouth and anus, and because it is bent in a complicated manner, the frictional force increases. Especially, when the lesion is in the deep small intestine, the endoscope cannot reach the deep part conventionally. It was difficult to observe. In addition, for example, in the case of endoscopic examination of the large intestine using a large intestine endoscope apparatus, depending on the skill of the large intestine endoscope operator, insertion of the large intestine endoscope into the deep large intestine is possible in about 10% of cases. There are difficult examples.

The reason is
(A) Since the force that pushes against the flexible endoscope is utilized, the endoscope bends and no force is applied to the distal end side.
(B) Since the endoscope is operated by grasping the endoscope operation part with the hand, the force application point is on the hand side of the endoscope, so that the force is applied to the distal end side of the flexible endoscope. Is not added,
(C) The frictional force between the endoscope and the digestive tract is large,
Etc.

  For example, FIG. 5 is a diagram showing a state in which the endoscope is inserted transanally, but since the sigmoid colon is greatly bent, the endoscope is greatly bent at the position indicated by the arrow. The state is shown schematically. In this state, it can be seen that, even if the sigmoid colon is pushed more strongly, only the sigmoid colon is excessively extended, and almost no force is transmitted in the direction of advancing the distal end side of the endoscope.

  In order to solve such problems of conventional endoscopes, endoscopes that enable observation and treatment of the deep part of the small intestine, collectively called balloon endoscopes, have been put into practical use. The balloon endoscope is provided with a balloon on the distal end side of the endoscope, and is called a single balloon type or a double balloon type depending on the number of balloons provided. By appropriately inflating the balloon inside, the outer cylinder part and the inner wall of the digestive tract can be fixed by a frictional force.

  For example, in the following Patent Document 1, an endoscope main body having a body fixing balloon attached to the outer periphery on the distal end side, a tube fixing balloon attached to the outer periphery on the distal end side, and the endoscope main body inserted therethrough. Each having a sliding tube for guiding the insertion of the endoscope main body, and a pump device for supplying air to each balloon. Each pump device measures the pressure of air in each balloon to measure the pressure in each balloon. An invention of a double balloon endoscope having a control means for controlling pressure is disclosed.

  As shown in FIG. 6, a double balloon endoscope 50 disclosed in Patent Document 1 below includes an endoscope body 51 and distal ends of sliding tubes 52 through which the endoscope body 51 is inserted. On the side, a main body fixing balloon 53 and a tube fixing balloon 54 are provided. The double-balloon endoscope 50 is inserted into the digestive tract with the main body fixing balloon 53 and the tube fixing balloon 54 deflated (FIG. 6A). It becomes difficult.

  Therefore, the tube fixing balloon 54 is inflated to fix the sliding tube 52 to the digestive tract, and then the endoscope main body 51 is advanced (FIG. 6B), and the main body fixing balloon 53 is inflated to fix the endoscope main body. After fixing to the digestive tract, the operation of advancing the distal end of the sliding tube 52 to the vicinity of the distal end of the endoscope main body 51 (FIG. 6C) is repeated to advance insertion into the deep part. It is something that can be done.

For example, when inserting into the deep small intestine, it is possible to insert deeper than before by repeating the operations (a) to (f) described below. That is,
(A) The endoscope main body 51 is inserted by a conventional method (pressed from the vicinity of the insertion portion).
(B) When it can no longer be pushed, the main body fixing balloon 53 attached to the distal end side of the endoscope main body 51 is inflated to fix the endoscope main body 51 (FIG. 6C).
(C) In a state where the endoscope main body 51 is fixed, the sliding tube 52 is pushed in from the vicinity of the insertion portion using the endoscope main body as a guide, so that the distal end side of the sliding tube 52 is connected to the main body fixing balloon 53. Advance to position (arrow 6C).
(D) The tube fixing balloon 54 attached to the distal end side of the sliding tube 52 is inflated to fix the sliding tube 52 (FIG. 6B).
(E) When the endoscope main body 51 and the sliding tube 52 are pulled back in a state where the sliding tube 52 is fixed, the small intestine on the near side from the fixed portion contracts, and the small intestine on the back side extends from the fixed portion.
(F) Since the small intestine on the back side from the fixing portion is extended, when the main body fixing balloon 53 is deflated, the endoscope main body 51 can be pushed further into the back (arrow in FIG. 6B).

JP 2002-301019 A

  According to the double balloon type endoscope device disclosed in Patent Document 1, it is easier to insert the endoscope into the small intestine than the conventional endoscope device. However, even with this double-balloon endoscope, it becomes difficult to advance the endoscope body as it is inserted into the back of the small intestine. This is because the endoscope is only hard rubber, so it is easy to bend, and the insertion method of the endoscope is to push it from the vicinity of the insertion part, which is the mouth or anus of the subject. Due to In other words, the friction increases each time the endoscope is inserted into the small intestine, and the endoscope is easily bent. Even if the endoscope is pushed in from the vicinity of the insertion portion, the distal end side of the endoscope is pushed forward. This is because it is difficult for force to be transmitted in the direction to do.

  If the force is applied so that the insertion device such as an endoscope is not pushed from the vicinity of the insertion portion but is pushed out from the distal end side of the outer tube, the present inventors bend the insertion device such as the endoscope. It is thought that it can be propelled without being influenced by ease, and if it is attached to the distal end side of the outer cylinder with a propelling balloon of an insertion device that can be expanded and contracted in the longitudinal direction, a fixed point is formed, and then inserted into the digestive tract In such a state, the present inventors have found that an insertion instrument such as an endoscope can be easily pushed out from the distal end side of the outer cylinder, and completed the present invention.

  That is, an object of the present invention is to provide a double-balloon endoscope apparatus that can easily advance an insertion instrument such as an endoscope and an outer tube even when inserted into a deep digestive tract.

In order to achieve the above object, a double balloon type endoscope apparatus of the present invention includes an outer cylinder and an insertion instrument inserted into the outer cylinder, and the outer end is provided on the outer periphery of the distal end portion of the outer cylinder. In a double-balloon endoscope apparatus in which a balloon for fixing a tube is formed, and a balloon for fixing the insertion instrument is formed on the outer periphery of the distal end of the insertion instrument,
A propulsion balloon of the insertion instrument is disposed between a distal end portion of the outer cylinder and a fixing balloon of the insertion instrument, and the propulsion balloon of the insertion instrument has the distal end side of the insertion instrument. Is fixed to the insertion instrument located on the proximal end side of the fixing balloon, and the proximal end side is fixed to the distal end of the outer cylinder, and the insertion cylinder is inserted into the outer cylinder or the insertion instrument. A gas flow path for introducing and sucking gas is formed inside the propulsion balloon of the instrument.

  In the double balloon type endoscope apparatus of the present invention, the propulsion balloon of the insertion instrument is disposed between the distal end portion of the outer cylinder and the fixing balloon of the insertion instrument, and is inserted into the outer cylinder or the insertion instrument. A gas flow path for introducing and sucking gas is formed inside the propulsion balloon of the instrument. After inflating the fixation balloon of the outer cylinder and fixing it in the body cavity, when the gas is introduced into the promotion balloon of the insertion instrument from the gas flow path, the insertion balloon of the insertion instrument extends from the distal end of the outer cylinder as a starting point Therefore, the distal end of the insertion instrument protrudes from the distal end of the outer cylinder. Since the force for driving the insertion instrument is given by the gas introduced into the propulsion balloon of the insertion instrument, the body cavity can be operated with a larger force than when the double balloon endoscope apparatus is pushed in from the operation portion side of the double balloon endoscope apparatus. Can be pushed in.

  Thereafter, the balloon for fixing the outer cylinder is deflated, the balloon for fixing the insertion instrument is inflated and fixed in the body cavity, and when the gas in the balloon for promoting the insertion instrument is sucked, the balloon for promoting the insertion instrument is deflated. Therefore, since the outer cylinder is drawn toward the distal end side of the insertion instrument starting from the distal end side of the insertion instrument, the outer cylinder can be further pushed into the body cavity. Also in this case, since the force for driving the outer cylinder is given by the gas sucked from the propulsion balloon of the insertion instrument, the force is larger than pushing the double balloon endoscope device from the operation portion side of the double balloon endoscope device. Can be pushed into the body cavity. According to the double balloon type endoscope apparatus of the present invention, by repeating the above operation, it can be more reliably inserted into the body cavity than the conventional double balloon type endoscope apparatus.

  That is, in the past, a doctor has pushed the endoscope by hand and inserted it. However, in the present invention, a propulsive force generating device is mounted on the distal end of the endoscope to self-propel the system. If such an endoscope is compared to a diesel train of 10-car train, in the conventional method, the 10th car at the end is a diesel locomotive with an engine mounted, and the passenger train is pushed from the tail, The train train is easy to be distorted and easily derailed around the fifth car. On the other hand, in the endoscope apparatus of the present invention, the leading vehicle is a diesel locomotive, which can be regarded as a state of pulling a passenger train and proceeding, and the distortion of the vehicle train is reduced compared to the conventional method (internal (The bending of the endoscope is reduced).

  Furthermore, because the endoscope (train) does not hit the large intestine wall (tunnel wall) by installing a propulsive force generator at the tip of the endoscope, it can prevent overextension of the intestinal tract and reduce pain. At the same time, the risk of perforation that breaks the large intestine wall can be avoided. If pain and anxiety about the examination of the subject are reduced, it is expected that the colorectal cancer examination rate will increase, and the possibility of reducing the number of deaths due to colorectal cancer is also expected.

  The gas flow path for introducing and sucking gas into the propulsion balloon of the insertion tool may be formed separately on the inner diameter side or the outer side of the outer cylinder, and the thickness of the outer cylinder is If there is enough, a gas flow path may be formed in the outer cylinder, and further, a gas flow path may be formed in the insertion instrument.

  In the double-balloon endoscope apparatus of the present invention, the propulsion balloon of the insertion instrument is in a stretched state and has an inner annular wall and an outer annular wall that hermetically surrounds the inner annular wall and is hollow inside. The outer surface of the annular cylindrical body on the distal end side of the inner annular wall is fixed to the outer periphery of the distal end side of the insertion instrument, and is close to the outer annular wall of the annular cylindrical body. It is preferable that the distal end side is fixed to the distal end side of the outer cylinder.

  When the propelling balloon of the insertion instrument has the above-described configuration, when the inside of the propulsion balloon of the insertion instrument is evacuated, the inner annular wall on the proximal end side of the propulsion balloon of the insertion instrument can be easily removed from the outer surface of the insertion instrument. Along the distal end side. Thereafter, when gas is introduced into the propulsion balloon of the insertion instrument, the inner annular wall on the proximal end side of the propulsion balloon of the insertion instrument is easily separated from the distal end side along the outer surface of the insertion instrument. . Therefore, according to the double-balloon endoscope apparatus of the present invention, the insertion instrument and the outer tube are smoothly placed in the back of the digestive tract by repeating the operation of introducing and exhausting the gas into the propulsion balloon of the insertion instrument. Can be inserted.

  Moreover, in the double balloon type endoscope apparatus of the present invention, the propulsion balloon of the insertion instrument may have the outer annular wall and the inner annular wall formed in a bellows shape.

  In the double balloon type endoscope apparatus of the present invention, the above-described effects can be obtained if both the outer annular wall and the inner annular wall of the propulsion balloon of the insertion instrument are formed of a flexible material. However, if the outer annular wall and the inner annular wall of the propulsion balloon of the insertion instrument are formed in a bellows shape, when a gas is introduced or exhausted into the propulsion balloon of the insertion instrument, a certain shape can be easily obtained. It becomes easy to deform in the maintained state. Moreover, when the propulsion balloon of the insertion instrument is formed in a bellows shape, when the gas is introduced into the propulsion balloon of the insertion instrument, it can be easily stretched in the length direction without greatly expanding in the radial direction. become able to. Therefore, according to the double balloon type endoscope apparatus of the present invention, by repeating the operation of introducing gas into the propulsion balloon of the insertion instrument and the operation of exhausting, the insertion instrument and the outer cylinder can be more smoothly reduced with less failure. It becomes possible to insert in the back of the digestive tract.

  In the double balloon endoscope device of the present invention, a coil spring is disposed inside the propulsion balloon of the insertion instrument, and one end of the coil spring is on the distal end side of the propulsion balloon of the insertion instrument. In addition, the other end may be fixed to the proximal end side of the propulsion balloon of the insertion instrument. In this case, the coil spring is preferably integrated with the outer annular wall.

  When the coil spring is inserted into the propulsion balloon of the insertion instrument, the compression force or expansion / contraction force of the coil spring can be used. Therefore, according to the double-balloon endoscope of the present invention, the pressure when introducing gas into the propulsion balloon of the insertion instrument or the pressure when exhausting gas from the propulsion balloon of the insertion instrument can be freely set. The degree increases.

  Moreover, when the coil spring is integrated with the outer annular wall, the gas does not swell greatly in the radial direction when gas is introduced into the propulsion balloon of the insertion instrument. Therefore, according to the double balloon type endoscope apparatus of the present invention, by repeating the operation of introducing gas into the propulsion balloon of the insertion instrument and the operation of exhausting, the insertion instrument and the outer tube can be more smoothly inserted into the back of the digestive tract. Can be inserted into.

  In the double-balloon endoscope apparatus according to the present invention, the propulsion balloon of the insertion instrument is partitioned into a plurality of chambers by at least one partition wall formed between the inner and outer diameter sides. In addition, an opening may be formed in the partition wall.

  When the chamber is partitioned into a plurality of chambers by at least one partition wall formed between the outer diameter side and the inner diameter side of the inside of the insertion device propulsion balloon, gas is introduced into the propulsion balloon of the insertion device. In such a case, it will not swell greatly in the radial direction. In addition, introduction of gas into the plurality of chambers or suction of gas from the plurality of chambers can be ensured by openings formed in the partition walls. Therefore, according to the double balloon type endoscope apparatus of the present invention, by repeating the operation of introducing gas into the propulsion balloon of the insertion instrument and the operation of exhausting, the insertion instrument and the outer tube can be more smoothly inserted into the back of the digestive tract. Can be inserted into.

  In the double balloon endoscope device of the present invention, the propulsion balloon may be wound around the insertion instrument in a spiral shape.

  When the propulsion balloon is wound around the insertion device in a spiral shape, the endoscope progresses efficiently without forming the annular wall of the balloon into a bellows shape or dividing the balloon into multiple chambers. It becomes possible to extend in the direction. Therefore, according to the double-balloon endoscope apparatus of the present invention, the insertion instrument and the outer tube are smoothly moved to the back of the digestive tract by repeating the operation of introducing and exhausting the gas into the propulsion balloon of the insertion instrument. Can be inserted.

  In the double balloon endoscope apparatus of the present invention, the outer cylinder is an endoscope main body, the insertion instrument can be a small diameter endoscope, and the outer cylinder is a sliding tube. In addition, the insertion instrument may be an endoscope body.

  According to the double balloon type endoscope apparatus of the present invention, the above-described excellent effects can be obtained in any of the combination of the endoscope main body and the small diameter endoscope and the combination of the sliding tube and the endoscope main body. Can be played.

FIG. 1A is a schematic cross-sectional view when the double balloon endoscope apparatus according to the first embodiment is inserted, and FIG. 1B is a schematic cross-sectional view when the endoscope main body of FIG. 1A is protruded. FIG. 5 is a schematic cross-sectional view when the sliding tube is further moved. FIG. 2A is a schematic cross-sectional view when the endoscope main body of the double balloon type endoscope apparatus according to the second embodiment is protruded, and FIG. 2B is a diagram of the double balloon type endoscope apparatus according to the third embodiment. FIG. 2C is a schematic cross-sectional view when the endoscope main body is protruded, and FIG. 2C is a schematic cross-sectional view when the endoscope main body of the double balloon endoscope apparatus according to the fourth embodiment is protruded. FIG. 3A is a schematic cross-sectional view of the double balloon endoscope device according to the fifth embodiment when inserted, and FIG. 3B is a schematic cross-sectional view when the small-diameter endoscope of FIG. 3A is projected. 3C is a schematic cross-sectional view when the endoscope main body is further moved. FIG. 4A is a schematic cross-sectional view when the endoscope main body of the double balloon type endoscope apparatus according to the sixth embodiment is protruded, and FIG. 4B is a diagram of the double balloon type endoscope apparatus according to the seventh embodiment. FIG. 4C is a schematic cross-sectional view when the endoscope main body is protruded, and FIG. 4C is a schematic cross-sectional view when the endoscope main body of the double-balloon endoscope apparatus according to the eighth embodiment is protruded. It is a schematic diagram which shows the insertion state of the conventional endoscope apparatus. It is a schematic diagram explaining the conventional double balloon type | mold endoscope apparatus.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. However, the embodiments shown below are for explaining an example for embodying the technical idea of the present invention, and are not intended to specify the present invention in these embodiments. The invention is equally applicable to other embodiments within the scope of the claims. In addition, in each drawing used for the description in this specification, each member is displayed with a different scale so that each member has a size that can be recognized on the drawing. Are not shown in proportion to the dimensions of the above, and there are parts that are not described for those parts that are not necessary for understanding the present invention.

[First Embodiment]
First, a schematic configuration of a double balloon endoscope device 10A according to the first embodiment of the present invention will be described with reference to FIG. 1A is a schematic cross-sectional view of the double-balloon endoscope apparatus according to the first embodiment when inserted, and FIG. 1B is a schematic cross-sectional view when the endoscope main body of FIG. 1A is projected. FIG. 1C is a schematic cross-sectional view when the sliding tube is further moved.

  The double balloon endoscope device 10A according to the first embodiment includes an endoscope body 11 and a sliding tube 12 through which the endoscope body 11 passes. The endoscope main body 11 is, for example, a colonoscope that has been conventionally used, and includes an illumination optical system (not shown) on the distal end side and various treatment tools inserted therein. A forceps hole 13 is formed. Also, a balloon 14 for fixing the sliding tube 12 is formed on the distal end side of the sliding tube 12. The fixing balloon 14 of the sliding tube 12 can be inflated or deflated by introducing or sucking a predetermined gas from the endoscope operation section (not shown) side.

  Further, the endoscope body 11 is formed with a balloon 15 for fixing the endoscope body 11 on the distal end side, is inserted into the sliding tube 12, and protrudes from the distal end side of the sliding tube 12. . The fixing balloon 15 of the endoscope body 11 can also be inflated or deflated by introducing or sucking a predetermined gas from the endoscope operation unit side. In the double balloon endoscope device 10A of the first embodiment, the sliding tube 12 and the fixing balloon 14 of the sliding tube 12 correspond to the outer tube and the outer tube fixing balloon of the present invention, respectively, and the endoscope main body. 11 and the balloon 15 for fixing the endoscope body 11 correspond to the insertion tool and the balloon for fixing the insertion tool of the present invention, respectively.

  In the double balloon endoscope device 10A according to the first embodiment, a propulsion balloon 16A for an insertion instrument is disposed between the distal end portion of the sliding tube 12 and the fixing balloon 15 of the endoscope body 11. ing. The propulsion balloon 16A of the insertion instrument is formed in a bellows shape, and has an inner annular wall 16a and an outer annular wall 16b that hermetically surrounds the inner annular wall 16a in the extended state, as shown in FIG. 1B. The inside is formed as a hollow annular cylindrical body, and a gap 16c is formed between the inner annular wall 16a and the endoscope body 11 except for a part on the distal end side. Yes.

  The pushing balloon 16A of the insertion instrument has the outer surface of the inner annular wall 16a on the distal end side fixed to the outer surface on the proximal end side of the fixing balloon 15 of the endoscope body 11, and The end side is fixed to the distal end of the sliding tube 12. In other words, the propulsion balloon 16A of the insertion instrument is such that a gap 16c is formed between the inner annular wall 16a and the outer peripheral side of the endoscope main body 11, and the distal end side is the outer peripheral side of the endoscope main body 11. The proximal end side is fixed to the distal end side of the sliding tube 12. The position where the pushing balloon 16A of the insertion instrument is fixed to the sliding tube 12 becomes a fixing point for pushing out the endoscope body 11.

  Further, a gas flow path 13a is formed in the endoscope body 11 for introducing gas into the propulsion balloon 16A of the insertion instrument and for sucking gas from the propulsion balloon 16A of the insertion instrument. Yes. The gas flow path 13a extends to the endoscope operation section, and can control the introduction and suction of gas into the propulsion balloon 16A of the insertion instrument from the endoscope operation section. Here, the gas flow path 13a formed in the endoscope main body 11 is communicated with the inside of the propulsion balloon 16A of the insertion instrument through the opening 13b formed on the distal end side of the endoscope main body 11. ing.

  As shown in FIG. 1A, the double-balloon endoscope apparatus 10A according to the first embodiment has the fixing balloons 14 and 15 deflated before insertion into the digestive tract, and a propulsion balloon 16A for the insertion instrument. Also wither. In this state, the double-balloon endoscope apparatus 10A is pushed into the digestive tract and inserted, and when it cannot be pushed any further, the fixation balloon 14 is inflated to fix the sliding tube 12 in the digestive tract.

  Next, when gas is introduced from the endoscope operation section side through the gas flow path 13a into the propulsion balloon 16A of the insertion instrument, the propulsion balloon 16A of the insertion instrument enters an extended state as shown in FIG. 1B. At this time, the distal end side of the pushing balloon 16A of the insertion instrument is fixed to the outer periphery of the endoscope body 11, and the proximal end of the pushing balloon 16A of the insertion instrument is fixed to the distal end of the sliding tube 12. Therefore, the propulsion balloon 16A of the insertion instrument is in an extended state starting from the distal end side of the sliding tube 12. As a result, the endoscope body 11 is further protruded from the distal end side of the sliding tube 12, so that the endoscope body 11 is further inserted into the digestive tract with a greater force than the double balloon endoscope apparatus 10A is inserted from the operation unit side. be able to.

  When the endoscope main body 11 protrudes by a predetermined amount from the distal end side of the sliding tube 12, the fixing balloon 15 of the endoscope main body 11 is inflated and the sliding balloon fixing balloon 14 is deflated. The endoscope body 11 is fixed in the digestive tract. In this state, when the gas is aspirated from the inside of the pushing balloon 16A of the insertion instrument through the gas flow path 13a on the endoscope operation unit side, the pushing balloon 16A of the inserting instrument moves on the distal end side of the endoscope main body 11. In order to wither as a starting point, a force for pulling the sliding tube 12 toward the distal end side is applied. Thereby, as shown in FIG. 1C, the distal end side of the sliding tube 12 can be moved to the distal end side of the endoscope body 11. Next, by appropriately repeating the operations shown in FIGS. 1B and 1C, the endoscope body 11 and the sliding tube 12 can be moved to the back of the digestive tract as in a conventional double-balloon endoscope apparatus. It becomes like this.

  Here, an example in which nothing is formed between the outer annular wall 16b and the inner annular wall 16a is shown as the propulsion balloon 16A of the insertion instrument. However, a means for restricting the distance between the outer annular wall 16b and the inner annular wall 16a so as not to exceed a certain value, for example, a fixed length of thread or sheet may be attached. If such a restricting means is provided, the gas does not swell in the radial direction when the gas is introduced into the propulsion balloon of the insertion instrument, so that it can be strongly stretched in the length direction.

  In the double balloon type endoscope apparatus 10A of the first embodiment, an example in which a gas flow path 13a for introducing or sucking gas into the propulsion balloon 16A of the insertion instrument is formed in the endoscope main body 11. However, a separate gas flow path may be formed inside or outside the sliding tube 12, and when the sliding tube 12 has a sufficient thickness, a gas flow path is formed in the sliding tube 12. May be.

  Further, in the double balloon endoscope device 10A of the first embodiment of the first embodiment, an example in which both the inner annular wall 16a and the outer annular wall 16b of the propulsion balloon 16A of the insertion instrument are bellows-like is shown. . However, as long as both the inner annular wall 16a and the outer annular wall 16b are formed of a flexible material, the same effect is produced. However, if the inner annular wall 16a and the outer annular wall 16b are accordion-shaped, they can be expanded and contracted while being deformed while maintaining a certain shape when the balloon 16A for propulsion of the insertion instrument is inflated or deflated. Therefore, the endoscope main body 11 and the sliding tube 12 can be inserted into the back of the digestive tract more smoothly with few failures.

[Second Embodiment]
Next, a double balloon endoscope device 10B of the second embodiment will be described with reference to FIG. 2A. FIG. 2A is a schematic cross-sectional view when the endoscope main body 11 of the double balloon endoscope device 10B according to the second embodiment is protruded.

  As shown in FIG. 2A, the double balloon endoscope device 10B of the second embodiment is configured except that a coil spring 16d is disposed so as to be integrated with the outer annular wall 16b in the propulsion balloon 16B of the insertion instrument. There is no difference in configuration from the double balloon endoscope device 10A of the first embodiment. Therefore, in FIG. 2A, the same reference numerals are given to the same components as those of the double balloon endoscope device 10A of the first embodiment, and detailed description thereof is omitted.

  When the coil spring 16d is inserted into the propulsion balloon 16B of the insertion instrument as in the double balloon endoscope device 10B of the second embodiment, the compression force or the expansion / contraction force of the coil spring 16d can also be used. . Therefore, the compression force remains in the coil spring 16d in the extended state of the propulsion balloon 16B of the insertion instrument, or the extension force remains in the deflated state of the propulsion balloon 16B of the insertion instrument. This makes it possible to arbitrarily change the pressure required when introducing the gas into the propulsion balloon 16B of the insertion instrument or the pressure required when exhausting the gas from the propulsion balloon 16B of the insertion instrument. .

  Moreover, when the coil spring 16d is arranged so as to be integrated with the outer annular wall 16b in the propulsion balloon 16B of the insertion instrument as in the double balloon endoscope apparatus 10B of the second embodiment, the propulsion balloon of the insertion instrument is arranged. When gas is introduced into 16B, it does not swell greatly in the radial direction. Therefore, the endoscope main body 11 and the sliding tube 12 can be more smoothly inserted into the back of the digestive tract by repeating the operation of introducing and exhausting gas into the propulsion balloon 16B of the insertion instrument. .

[Third Embodiment]
Next, a double balloon endoscope device 10C according to a third embodiment will be described with reference to FIG. 2B. 2B is a schematic cross-sectional view when the endoscope main body 11 of the double balloon endoscope device 10C according to the third embodiment is protruded.

  As shown in FIG. 2B, the double-balloon endoscope apparatus 10C of the third embodiment has at least one between the inner annular wall 16a and the outer annular wall 16b inside the propulsion balloon 16C of the insertion instrument. One partition wall 16e is provided and partitioned into a plurality of chambers 16f, and an opening 16g is formed in each partition wall 16e. With such a configuration, when the gas is introduced into the propulsion balloon 16C of the insertion instrument, it does not swell greatly in the radial direction, and the introduction of gas into the plurality of chambers 16f or from the plurality of chambers 16f is prevented. The suction of the gas can be ensured by the opening 16g formed in the partition wall 16e. Therefore, also in the double balloon type endoscope device 10C of the third embodiment, the endoscope main body 11 and the sliding can be more smoothly performed by repeating the operation of introducing and exhausting gas into the propulsion balloon 16C of the insertion instrument. The tube 12 can be inserted into the back of the digestive tract.

[Fourth Embodiment]
Next, a double balloon endoscope device 10D of the fourth embodiment will be described with reference to FIG. 2C. FIG. 2C is a schematic cross-sectional view when the endoscope main body 11 of the double balloon endoscope device 10D according to the fourth embodiment is protruded.

  In the double balloon endoscope device 10D of the fourth embodiment, as shown in FIG. 2C, the propulsion balloon 16D of the insertion instrument is fixed in a coiled state. The propulsion balloon 16D has one end fixed to the distal end of the sliding tube 12, the other end fixed to the distal end side of the endoscope body 11, and the inside thereof being open. It communicates with the gas channel 13a via 13b.

  With such a configuration, it is possible to efficiently extend in the propulsion direction of the endoscope without providing the partition wall 16e and the opening 16g as shown in the third embodiment. For example, assuming that the balloon is wound 10 times and the diameter of the balloon is expanded by 5 mm by introducing gas, the balloon expands in the radial direction of the endoscope by 5 mm × 2 = 1 cm over the entire balloon portion. On the other hand, the extension of the balloon in the longitudinal direction of the endoscope is 5 mm × 10 = 5 cm in the entire balloon portion.

  Therefore, also in the double balloon endoscope device 10D of the present embodiment, the endoscope main body 11 and the sliding tube 12 are digested by repeating the operation of introducing and exhausting gas into the propulsion balloon 16D of the insertion instrument. It can be inserted into the back of the tube. The propulsion balloon 16D only needs to have a coil shape when it is fixed to the endoscope body 11 and the sliding tube 12, so that the balloon formed in a coil shape is naturally formed in a straight or curved shape. Even a balloon can be applied to the present embodiment as the propulsion balloon 16D.

[Fifth Embodiment]
Next, a schematic configuration of a double balloon endoscope device 10E according to a fifth embodiment of the present invention will be described with reference to FIG. 3A is a schematic cross-sectional view when the double balloon endoscope device 10E according to the fifth embodiment is inserted, and FIG. 4B is a schematic cross-sectional view when the small-diameter endoscope 11a of FIG. 4A is protruded. FIG. 4C is a schematic cross-sectional view when the endoscope body 11 is further moved. In FIG. 4, the same components as those in the double balloon endoscope device 10A of the first embodiment shown in FIG.

  In the double balloon type endoscope devices 10A to 10C of the first to third embodiments, the configuration corresponding to the insertion instrument of the present invention is the endoscope body 11, and the configuration corresponding to the outer cylinder of the present invention is the sliding tube 12. However, in the double balloon endoscope device 10E of the fifth embodiment, the configuration corresponding to the insertion instrument of the present invention is the small-diameter endoscope 11a, and the configuration corresponding to the outer cylinder of the present invention. Corresponds to the endoscope body 11.

  The thin endoscope 11a has an outer diameter of about 5 mm or less that can be inserted into the forceps hole 13 of the endoscope body 11, and includes a treatment instrument insertion port 13c therein. Since it has a small diameter, no illumination optical system is provided. When an illumination optical system is required for guiding the thin endoscope 11a, the thin endoscope 11a is separately inserted into the treatment instrument insertion port 13c of the thin endoscope 11a. Can be guided to a predetermined position. Then, after guiding the microscopic endoscope 11a to a predetermined position, the illumination optical system is taken out from the treatment instrument insertion port 13c, and various treatment tools are inserted into the treatment instrument insertion port 13c. Done.

  A double balloon endoscope device 10E of the fifth embodiment includes an endoscope main body 11 as shown in FIG. The endoscope main body 11 is, for example, a colonoscope that has been conventionally used, and includes an illumination optical system (not shown) on the distal end side and various treatment tools inserted therein. A forceps hole 13 is formed. Here, a small-diameter endoscope 11 a is inserted into the forceps hole 13. The small-diameter endoscope 11a extends to the endoscope operation unit. Further, a fixing balloon 14 is formed on the distal end side of the endoscope main body 11, and a fixing balloon 15 of the small diameter endoscope 11a is formed on the distal end side of the small diameter endoscope 11a. Is formed. The fixing balloons 14 and 15 can be inflated or deflated by introducing or sucking a predetermined gas from the endoscope operation section side.

  In the double balloon endoscope device 10E according to the fifth embodiment, a propulsion balloon 16E for an insertion instrument is provided between the distal end portion of the endoscope main body 11 and the fixing balloon 15 of the small diameter endoscope 11a. Is arranged. The propulsion balloon 16E of the insertion instrument is formed in a bellows shape, and has an inner annular wall 16a and an outer annular wall 16b that hermetically surrounds the inner annular wall 16a in the extended state, as shown in FIG. 3B. The inside is formed into a hollow annular cylindrical body, and a gap 16c is formed between the inner annular wall 16a and the small-diameter endoscope 11a except for a part on the distal end side. ing.

  The pushing balloon 16E of the insertion instrument has the outer surface of the inner annular wall 16a on the distal end side fixed to the outer surface on the proximal end side of the fixing balloon 15 of the small diameter endoscope 11a. The distal end side is fixed to the distal end of the endoscope body 11. In other words, the propulsion balloon 16E of the insertion instrument has a gap 16c formed between the inner annular wall 16a and the outer peripheral side of the small diameter endoscope 11a, and the distal end side of the small diameter endoscope 11a. The proximal end side is fixed to the outer peripheral side, and the proximal end side is fixed to the distal end side of the endoscope body 11. The position where the balloon 16E for propulsion of the insertion instrument is fixed to the endoscope body 11 becomes a fixing point for pushing out the small diameter endoscope 11a.

  Further, a gas flow path 13a is formed in the endoscope body 11 to introduce gas into the propulsion balloon 16E of the insertion instrument and to suck gas from the propulsion balloon 16E of the insertion instrument. Yes. This gas flow path 13a extends to the endoscope operation section, and can control the introduction and suction of gas into the propulsion balloon 16E of the insertion instrument from the endoscope operation section. Here, the gas flow path 13a formed in the endoscope body 11 is communicated with the inside of the propulsion balloon 16E of the insertion instrument through the opening 13b formed on the distal end side of the endoscope body 11. Yes.

  As shown in FIG. 3A, the double-balloon endoscope apparatus 10E according to the fifth embodiment has the balloons for fixation 14 and 15 deflated before being inserted into the digestive tract, and a propulsion balloon 16E for the insertion instrument. Also wither. In this state, the double balloon endoscope device 10E is pushed into the digestive tract and inserted, and when it cannot be pushed any further, the fixing balloon 14 is inflated to fix the endoscope body 11 in the digestive tract.

  Next, when gas is inserted into the propulsion balloon 16E of the insertion instrument from the endoscope operation section side through the gas flow path 13a, the propulsion balloon 16E of the insertion instrument is in an extended state as shown in FIG. 3B. At this time, the distal end side of the pushing balloon 16E of the insertion instrument is fixed to the outer periphery of the small diameter endoscope 11a, and the proximal end of the pushing balloon 16E of the insertion instrument is the distal end of the endoscope body 11. Therefore, the propulsion balloon 16E of the insertion instrument is in an extended state starting from the distal end side of the endoscope body 11. As a result, the small-diameter endoscope 11a is further protruded from the distal end side of the endoscope main body 11, so that it can be further moved into the digestive tract with a larger force than the double balloon endoscope device 10E is inserted from the operation unit side. Can be inserted.

  When the small-diameter endoscope 11a protrudes a predetermined amount from the distal end side of the endoscope main body 11, the fixing balloon 15 of the small-diameter endoscope 11a is inflated and the fixing balloon of the endoscope main body 11 is expanded. 14 is deflated, and the small-diameter endoscope 11a is fixed in the digestive tract. In this state, when the gas is sucked from the propulsion balloon 16E of the insertion instrument through the gas flow path 13a on the endoscope operation section side, the propulsion balloon 16E of the insertion instrument is on the distal end side of the small-diameter endoscope 11a. Therefore, a force for pulling toward the distal end side is applied to the endoscope main body 11. Thereby, as shown in FIG. 3C, the distal end side of the endoscope body 11 can move to the distal end side of the small-diameter endoscope 11a. Next, by appropriately repeating the operations shown in FIGS. 3B and 3C, the endoscope main body 11 and the small-diameter endoscope 11a are moved to the back of the digestive tract as in a conventional double-balloon endoscope apparatus. Will be able to.

[Sixth Embodiment]
Next, a double balloon endoscope device 10F according to a sixth embodiment will be described with reference to FIG. 4A. FIG. 4A is a schematic cross-sectional view when the small-diameter endoscope 11a of the double-balloon endoscope apparatus 10F according to the sixth embodiment is protruded.

  As shown in FIG. 4A, the double balloon endoscope device 10F of the sixth embodiment is configured except that the coil spring 16d is disposed so as to be integrated with the outer annular wall 16b in the propulsion balloon 16F of the insertion instrument. There is no difference in configuration from the double balloon endoscope device 10C of the fifth embodiment. Therefore, in FIG. 4A, the same reference numerals are given to the same components as those of the double balloon endoscope device 10C of the fifth embodiment, and the detailed description thereof is omitted.

  When the coil spring 16d is inserted into the propulsion balloon 16F of the insertion instrument as in the double balloon endoscope device 10F of the sixth embodiment, the compressive force or expansion / contraction force of the coil spring 16d can also be used. . Therefore, the compression force remains in the coil spring 16d when the propulsion balloon 16F of the insertion instrument is extended, or the extension force remains when the propulsion balloon 16F of the insertion instrument is deflated. As a result, the pressure required to introduce gas into the propulsion balloon 16F of the insertion instrument or the pressure required to exhaust gas from the propulsion balloon 16F of the insertion instrument can be arbitrarily changed. .

  Moreover, when the coil spring 16d is arranged so as to be integrated with the outer annular wall 16b in the propulsion balloon 16F of the insertion instrument as in the double balloon endoscope apparatus 10F of the sixth embodiment, the propulsion balloon of the insertion instrument is arranged. When gas is introduced into 16F, it does not swell greatly in the radial direction. Therefore, the endoscope main body 11 and the small-diameter endoscope 11a can be more smoothly inserted into the back of the digestive tract by repeating the operation of introducing and exhausting the gas into the propulsion balloon 16F of the insertion instrument. It becomes like this.

[Seventh Embodiment]
Next, a double balloon endoscope device 10G of the seventh embodiment will be described with reference to FIG. 4B. FIG. 4B is a schematic cross-sectional view when the small-diameter endoscope 11a of the double balloon endoscope apparatus 10G according to the seventh embodiment is protruded.

  As shown in FIG. 4B, the double balloon endoscope device 10G of the seventh embodiment has at least one between the inner annular wall 16a and the outer annular wall 16b inside the propulsion balloon 16G of the insertion instrument. One partition wall 16e is provided and partitioned into a plurality of chambers 16f, and an opening 16g is formed in each partition wall 16e. With such a configuration, when the gas is introduced into the propulsion balloon 16G of the insertion instrument, it does not swell greatly in the radial direction, and the introduction of the gas into the plurality of chambers 16f or from the plurality of chambers 16f is prevented. The suction of the gas can be ensured by the opening 16g formed in the partition wall 16e. Therefore, also in the double balloon type endoscope apparatus 10G of the seventh embodiment, the operation of introducing and exhausting gas into the propulsion balloon 16G of the insertion instrument is repeated, so that the endoscope main body 11 and the finer endoscope apparatus 10G can be smoothed. It becomes possible to insert the endoscope 11a into the back of the digestive tract.

[Eighth Embodiment]
Next, a double balloon endoscope device 10H according to an eighth embodiment will be described with reference to FIG. 4C. FIG. 4C is a schematic cross-sectional view when the small-diameter endoscope 11a of the double balloon endoscope device 10H according to the eighth embodiment is protruded.

  In the double balloon endoscope device 10H of the eighth embodiment, as shown in FIG. 4C, the propulsion balloon 16H of the insertion instrument is fixed in a coiled state. The propulsion balloon 16H has one end fixed to the distal end side of the small-diameter endoscope 11a and the other end fixed to the distal end of the endoscope body 11. The inside communicates with the gas flow path 13 through the opening 13b.

  With such a configuration, it is possible to efficiently extend in the propulsion direction of the endoscope without providing the partition wall 16e and the opening 16g as shown in the seventh embodiment. For example, assuming that the balloon is wound 10 times and the diameter of the balloon is expanded by 5 mm by introducing gas, the balloon expands in the radial direction of the endoscope by 5 mm × 2 = 1 cm over the entire balloon portion. On the other hand, the extension of the balloon in the longitudinal direction of the endoscope is 5 mm × 10 = 5 cm in the entire balloon portion.

  Therefore, also in the double balloon type endoscope apparatus 10H of the present embodiment, the endoscope main body 11 and the small diameter endoscope are repeated by repeating the operation of introducing and exhausting gas into the propulsion balloon 16H of the insertion instrument. 11a can be inserted into the back of the digestive tract. The propulsion balloon 16H only needs to have a coil shape when it is fixed to the small-diameter endoscope 11a and the endoscope main body 11. Therefore, the balloon formed in the coil shape is naturally straight or curved. Even the balloon formed in the above can be applied to the present embodiment as the propulsion balloon 16H.

  DESCRIPTION OF SYMBOLS 10A-10H ... Double balloon type | mold endoscope apparatus 11 ... Endoscope main body 11a ... Small diameter endoscope 12 ... Sliding tube 13 ... Forceps hole 13a ... Gas flow path 13b ... (gas flow path) opening 13c ... (thin) Treatment tool insertion port 14, 15 ... Fixing balloons 16A, 16B, 16C, 16D, 16E, 16F, 16G, 16H ... Propulsion balloon 16a ... Inner annular wall 16b ... Outer annular wall 16c ... gap 16d ... coil spring 16e ... partition wall 16f ... (multiple) chamber 16g ... opening

Claims (9)

An outer cylinder, and an insertion instrument inserted into the outer cylinder, and a balloon for fixing the outer cylinder is formed on the outer periphery of the distal end of the outer cylinder, and on the outer periphery of the distal end of the insertion instrument Is a double balloon type endoscope apparatus in which a balloon for fixing the insertion instrument is formed,
Between the distal end of the outer cylinder and the fixing balloon of the insertion instrument, a propulsion balloon of the insertion instrument is disposed,
The propulsion balloon of the insertion instrument has a distal end fixed to the insertion instrument positioned on the proximal end of the fixation balloon of the insertion instrument, and a proximal end fixed to the distal end of the outer tube. Has been
A double-balloon endoscope apparatus, wherein the outer tube or the insertion instrument is formed with a gas flow path for introducing and sucking gas into the propulsion balloon of the insertion instrument.   The propulsion balloon of the insertion instrument is a stretched state, and has an inner annular wall and an outer annular wall that hermetically surrounds the inner annular wall, and is formed of a hollow annular cylindrical body. The outer surface of the distal end side of the wall is fixed to the outer periphery of the distal end side of the insertion instrument, and the proximal end side of the outer annular wall of the annular cylindrical body is fixed to the distal end side of the outer cylinder. The double-balloon endoscope apparatus according to claim 1, wherein   The double balloon type endoscope apparatus according to claim 2, wherein the propulsion balloon of the insertion instrument has the outer annular wall and the inner annular wall formed in a bellows shape.   A coil spring is disposed inside the propulsion balloon of the insertion instrument, and one end of the coil spring is on the distal end side of the propulsion balloon of the insertion instrument and the other end is proximal to the propulsion balloon of the insertion instrument. The double-balloon endoscope apparatus according to claim 2, wherein the double-balloon endoscope apparatus is fixed to each end side.   The double balloon endoscope apparatus according to claim 4, wherein the coil spring is integrated with the outer annular wall.   The propulsion balloon of the insertion instrument is partitioned into a plurality of chambers by at least one partition formed between an inner diameter side and an inner diameter side, and an opening is formed in the partition wall. The double-balloon endoscope apparatus according to claim 2,   The double balloon endoscope apparatus according to claim 1, wherein the propulsion balloon of the insertion instrument is wound around the insertion instrument in a spiral shape.   The double balloon type endoscope apparatus according to any one of claims 1 to 7, wherein the outer cylinder is an endoscope main body, and the insertion instrument is a small diameter endoscope.   The double balloon endoscope apparatus according to any one of claims 1 to 7, wherein the outer cylinder is a sliding tube, and the insertion instrument is an endoscope body.